Obesity Surgery

, Volume 14, Issue 6, pp 744–749

Manometric Abnormalities and Gastroesophageal Reflux Disease in the Morbidly Obese

  • Dennis Hong
  • Yashodhan S Khajanchee
  • Natasha Pereira
  • Barbara Lockhart
  • Emma J Patterson
  • Lee L Swanstrom
Article

DOI: 10.1381/0960892041590854

Cite this article as:
Hong, D., Khajanchee, Y.S., Pereira, N. et al. OBES SURG (2004) 14: 744. doi:10.1381/0960892041590854

Background: Obesity is an epidemic in the USA. Many disorders are associated with obesity including gastroesophageal reflux disease (GERD). However, the prevalence of GERD and esophageal motility disorders in the morbidly obese population is unclear. Methods: During evaluation for bariatric surgery, 61 morbidly obese patients underwent preoperative 24-hr pH and esophageal manometry. A single reviewer evaluated all 24-hr pH and manometric tracings. Johnson-DeMeester score >14.7 was considered diagnostic of GERD. Manometric criteria for motility disorders were from published values. All values are given as mean ± SD. Results: Mean age was 44.4 + 10.3 years. 55 of the patients (90%) were female. Mean BMI was 50.1 ± 7.2 kg/m2. 23 patients (38%) complained of GERD symptoms (reflux and/or heartburn). 1 patient (2%) complained of noncardiac chest pain. Mean Johnson-DeMeester score was 19.6 ± 17.8. Mean intragastric and intrabolus pressures were both elevated (8.3 ± 1.6 mmHg and 15 ± 9 mmHg). 33 patients (54%) had abnormal manometric findings: 10 had a mechanically defective LES, 11 had a hypertensive LES, 2 had diffuse esophageal spasm, 3 had nutcracker esopha gus,1 had ineffective esophageal disorder and 14 had nonspecific esophageal motility disorder. Some patients had more than one disorder. 20 patients (33%) had significantly elevated (>180 mmHg) contraction amplitudes at the most distal channel (210.0 ± 28.7 mmHg). Conclusions: Prevalence of manometric abnormalities in the morbidly obese is high. Presence of a nut cracker-like distal esophagus in the morbidly obese is significant and warrants further evaluation.

MORBID OBESITY ESOPHAGEAL MOTILITY GASTRO-ESOPHAGEAL REFLUX 

Copyright information

© Springer 2004

Authors and Affiliations

  • Dennis Hong
    • Yashodhan S Khajanchee
      • Natasha Pereira
        • Barbara Lockhart
          • Emma J Patterson
            • Lee L Swanstrom

              There are no affiliations available

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